Objective:

To critically evaluate the efficacy and safety of oblique lumbar interbody fusion (OLIF) versus transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar spondylolisthesis (DLS).

Methods:

PubMed, Embase, Cochrane Library, Web of Science Core Collection, Chinese Biomedical Literature, China National Knowledge Infrastructure, Wanfang Digital Periodicals, and Chinese Science and Technology Periodicals were searched from inception to February 2021. Randomized controlled trials (RCTs), and retrospective or prospective cohort studies (CSs) comparing OLIF with TLIF for DLS were included. The meta-analysis was conducted if possible.

Results:

Ten studies were included for the statistical analysis. The pooled results of CSs showed no statistically significant differences (P > 0.05) in pain relief at 3 or 6 months’ follow-up and function improvement at 1 or 3 months’ follow-up in DLS patients between OLIF and TLIF. The pooled results of CSs showed that OLIF could significantly improve the degree of lumbar lordosis, foraminal height and disc height, decrease intraoperative blood loss, postoperative drainage volume, operative duration, bed rest time and length of hospital stay (P < 0.05) compared with TLIF. The incidence of adverse events was not statistically different between OLIF and TLIF.

Conclusions:

This study suggests that pain relief and function improvement are not significantly different between OLIF and TLIF. Nevertheless, OLIF may improve radiological outcomes, and reduce intraoperative blood loss, postoperative drainage volume, operative duration, bed rest time, and length of hospital stay compared with TLIF. Additional high-quality RCTs are still needed to confirm these findings.